The Center for Behavioral Health Statistics and Quality (CBHSQ) has been hard at work determining where in each state opioid treatment programs (OTPs) are needed, due to lack of services. CBHSQ is a division of the Substance Abuse and Mental Health Services Administration (SAMHSA).
The maps won’t be ready for public distribution until later this spring, but SAMHSA gave states preliminary drafts to help them prepare their applications for Cures Act funding. Those applications were due February 17 and went through Single State Authorities in charge of the Substance Abuse Prevention and Treatment (SAPT) block grant, also administered by SAMHSA.
Funding for Opioid Use Disorders
The Cures Act was passed by Congress and signed by President Obama in December of 2016. It provides $500 million in funding for each of fiscal years 2017 and 2018, 80% of which must go directly to treatment for opioid use disorders.
This is an excellent opportunity to bring what’s being done best in some states to other states—for example, the Hub and Spoke system of Vermont (in fact, through the Cures Act money, California is now going to adopt this system—see related story).
“It’s too early to put the maps out in public,” Kimberly A. Johnson, PhD, director of SAMHSA’s Center for Substance Abuse Treatment, told AT Forum. CBHSQ is working on an academic paper describing the methodology for the maps, she said, adding, “We want to make sure that we haven’t left anything out” that would make the methodology inaccurate.
According to Dr. Johnson, useful data for determining where the needs are include more requests for treatment, waiting lists at current OTPs, and higher rates of overdose. Poison control centers also have important information, she said.
There are ways that treatment can be expanded in current OTPs, but they are problematic. Interim methadone isn’t a solution for many programs; although it would allow them to enroll new patients without providing extra services, such as counseling, the additional services would have to be in place within 120 days.
The Africa story Dr. Johnson tells—of clinics that simply give methadone to anybody who comes in and needs it—is not possible in the United States, due to regulations. Why can’t it happen here? “It should,” she said.
Goal: Expand Access to Care
In the meantime, SAMHSA is working on expanding access to care. “That is a clear goal for us,” said Dr. Johnson. “That is a goal that the administration has expressed, including expanding funding to the States.”